- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.00 / $6,338.70 / $13,101.00
| Facility | | $1,819.00 | $6,338.70 | $13,101.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $422.98 / $673.80 / $756.38
| Professional | | $422.98 | $673.80 | $756.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,989.00 / $9,750.00 / $16,411.00
| Facility | | $4,989.00 | $9,750.00 | $16,411.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $425.37 / $504.92 / $857.15
| Professional | | $425.37 | $504.92 | $857.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,511.50 / $5,511.50 / $16,534.50
| Facility | | $5,511.50 | $5,511.50 | $16,534.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $485.18 / $485.18 / $7,227.90
| Facility | | $485.18 | $485.18 | $7,227.90 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $405.15 / $2,020.59 / $2,020.59
| Professional | | $405.15 | $2,020.59 | $2,020.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38,357.00 / $47,648.00 / $71,078.00
| Facility | | $38,357.00 | $47,648.00 | $71,078.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.58 / $597.86 / $795.52
| Professional | | $398.58 | $597.86 | $795.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $485.18 / $597.00 / $74,999.25
| Facility | | $485.18 | $597.00 | $74,999.25 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $405.15 / $2,020.59 / $2,020.59
| Professional | | $405.15 | $2,020.59 | $2,020.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,705.00 / $7,719.00 / $17,688.00
| Facility | | $2,705.00 | $7,719.00 | $17,688.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $467.55 / $775.82 / $1,852.88
| Professional | | $467.55 | $775.82 | $1,852.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $410.06 / $410.06 / $410.06
| Facility | | $410.06 | $410.06 | $410.06 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $410.06 / $620.58 / $860.24
| Professional | | $410.06 | $620.58 | $860.24 |